Treating premature ejaculation


October 25, 2016

Dear Readers,

Whenever FAB has sex with his wife, she gets angry because he ejaculates within minutes. He asks for help.

Premature ejaculation is when a man has an orgasm before he really wants to, resulting in unsatisfactory sex for both partners. It often results in performance anxiety, which just worsens the problem totally.

It is a very common male sexual dysfunction which mostly affects young men. It is usually a temporary problem occurring under a time of stress and most often is not due to a physical, but a mental cause. Some men suffer from this condition occasionally, but when the problem is prolonged the man should see a physician.

The average length of intercourse for most couples is under six minutes, but there is no definition of how long sexual intercourse should last. Statistics show that about one -third of men in the US want to extend intercourse to prolong pleasure both for themselves and partners.

Some important causes of premature ejaculation are:

• Some men have anxiety when sexually active and do not want to expose their anxiety. Hence, they do not concentrate on the sexual act or the pleasure but, rather, are focused on the anxiety.

n Depression.

n Relationship problems.

n Some men have erectile dysfunction and have issues with the strength and fullness of the erection. The man may be in a hurry to complete the act before losing his erection and this also can result in premature ejaculation.

n Hormonal imbalance. This occurs with thyroid disorders and low serotonin hormone production.

n Medical problems. Premature ejaculation can occur due to prostate gland problems.

n Men who take narcotics and other similar drugs can also experience premature ejaculation.

n Side effect of medical drugs used.

n Some men (few) have always suffered with premature ejaculation since first becoming sexually active. This could be due to conditioning. If a man used to masturbate and ejaculate quickly, this can influence later sexual behaviour. It can be difficult to break the habit of a quick orgasm.

n Sexual abuse.

n Strict upbringing and stern religious beliefs.

n Extra penile sensitivity.

Most cases of premature ejaculation do not have a clear cause. Most men with sexual experience and age learn to delay orgasm, but sometimes it will still occur at the start of a relationship with a new partner or if a man hasn't ejaculated for a long time previously. There are a number of actions a man can take to reduce this problem:

n Masturbate an hour before having sexual intercourse. This takes the edge off sex in a man with a normal erection.

n Use a doubled or extra thick condom to decrease penile sensitivity and allow for longer intercourse before orgasm.

n Have sex with your partner on top so that she can pull away when it seems you are near to ejaculating.

n Take breaks during sexual intercourse - stop-and-go technique.

n Couples therapy, which a couple can practise and which helps to unlearn premature ejaculation. Called the 'squeeze' technique, the partner masturbates the man but stops before ejaculation occurs and squeezes down on the head of the penis for 10 to 20 seconds. The partner then releases the penis and waits another 30 seconds before resuming caressing the penis. This action is repeated several times before the man is allowed to ejaculate. This therapy requires some practice to get it right.


n SSRI Antidepressants. These are used to treat depression but also delay ejaculation. These include Paroxetine (Paxil), Sertraline (Zoloft), and Fluoxetine (Prozac). Usually, these prescribed medications have to be taken for a couple weeks before full effects are seen. An older antidepressant, Anafranil, is also used to delay ejaculation. It is inexpensive and works well.

n Topical anaesthetics, e.g. Lidocaine. When used, these applications decrease the penile sensitivity and allow the man to participate longer before feeling like he has to ejaculate.

n Beta-blockers used in the treatment of hypertension can also be used to delay ejaculation.

n Tramadol, a pain medication, is also prescribed for treatment of premature ejaculation.

n Drugs like Viagra, Levitra and Cialis, which are prescribed to assist with erection, can also be used to help premature ejaculation.

Studies show that a combination of psychological counselling and medications may be the most effective method to resolve premature ejaculation, and evaluation by a sex therapist or psychologist should be considered if other methods tried fail. It should also be noted that in many instances, premature ejaculation improves over time without treatment. Cutting down on the use of alcohol, cigarette smoking and use of illegal drugs also helps.

If a man is prone to premature ejaculation, it serves him well to pleasure his partner and to bring that person almost to the point of orgasm before having intercourse. That way the partner is usually happy, although the man might still want the prematurity treated.

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